for low testosterone
Treatment options
Treatment of low testosterone is straightforward. Once the decision has been made to treat testosterone deficiency, low testosterone can be increased by using one of a number of treatment options. All of these treatment options require a doctor’s prescription. An ideal form of testosterone treatment will increase testosterone levels to a point within the normal range that aim to result in disappearance of your bothersome symptoms.1-7 It will also offer a convenient dosing schedule and way of administration.
It is important to keep in mind that it may take 6-12 months of uninterrupted testosterone therapy for your symptoms to improve.9 In fact, symptoms can continue to improve for 2 years, and erectile dysfunction can continue to improve for as long as 9 years with uninterrupted testosterone therapy.10
A reason for lack of response to testosterone therapy among men who report that “it didn’t work” is sub-optimal dosing resulting in failure to achieve a large enough elevation in testosterone levels (within the middle of the normal range), or that they stopped the treatment too soon. Regular monitoring of testosterone levels and changes in symptoms (or lack thereof) will tell if any dose-adjustments of given testosterone medication are needed.
Health and well-being – quality of life
Treatment can improve signs and symptoms of low testosterone, such as sexual problems, physical functioning and depressive moods, can be expected over time and will show you that the treatment is working.12
Body composition
Testosterone replacement in men with low testosterone plus lifestyle interventions (e.g. diet) may lead to increased lean body mass and strength and decreased fat mass.13
Bone
Low testosterone can lead to thinning of the bones (osteoporosis) and men with hip fractures tend to have low testosterone. Testosterone replacement may lead to increased bone density.3
If low testosterone occurs during adulthood, you can make some lifestyle and dietary changes to help prevent osteoporosis. Regular exercise and adequate amounts of calcium and vitamin D help to maintain bone strength and are
important to reduce the risk of osteoporosis.
Just like any other medicine, there may be some adverse effects with the use of testosterone replacement therapy. These risks and the potential benefits will be evaluated by your doctor but it is important that you understand
them. If you and your doctor agree to start testosterone therapy then please refer to that products patient information leaflet (PIL) to see a full list of potential adverse events.
References
- Salonia A, Bettocchi C, Carvalho J, et al. 2020 EAU Guidelines on Sexual and Reproductive Health.
- Morgentaler A, Traish A, Hackett G, Jones TH, Ramasamy R. Diagnosis and Treatment of Testosterone Deficiency: Updated Recommendations From the Lisbon 2018 International Consultation for Sexual Medicine. Sex Med Rev. 2019;7(4):636-649.
- Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine. 2017;14(12):1504-1523.
- Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. The journal of sexual medicine. 2015;12(8):1660-1686.
- Khera M, Adaikan G, Buvat J, et al. Diagnosis and Treatment of Testosterone Deficiency: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). The journal of sexual medicine. 2016;13(12):1787-1804.
- Morales A, Bebb RA, Manjoo P, et al. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. CMAJ. 2015;187(18):1369-1377.
- Lunenfeld B, Mskhalaya G, Zitzmann M, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. The ageing male : the official journal of the International Society for the Study of the Ageing Male. 2015;18(1):5-15.
- Saad F, Aversa A, Isidori AM, Zafalon L, Zitzmann M, Gooren L. Onset of effects of testosterone treatment and time span until maximum effects are achieved. Eur J Endocrinol. 2011;165(5):675-685.
- Saad F, Caliber M, Doros G, Haider KS, Haider A. Long-term treatment with testosterone undecanoate injections in men with hypogonadism alleviates erectile dysfunction and reduces risk of major adverse cardiovascular events, prostate cancer, and mortality. The ageing male : the official journal of the International Society for the Study of the Ageing Male. 2020;23(1):81-92.
-
EAU Guidelines on Sexual and Reproductive Health, 3. Male Hypogonadism 2022. Available at:https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Sexual-and-Reproductive-Health-2022_2022-03-29-084141_megw.pdf. Accessed February 2022.
- Corona G, et al. Andrology. 2020:8;970–87.
References
- Salonia A, Bettocchi C, Carvalho J, et al. 2020 EAU Guidelines on Sexual and Reproductive Health.
- Morgentaler A, Traish A, Hackett G, Jones TH, Ramasamy R. Diagnosis and Treatment of Testosterone Deficiency: Updated Recommendations From the Lisbon 2018 International Consultation for Sexual Medicine. Sex Med Rev. 2019;7(4):636-649.
- Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine. 2017;14(12):1504-1523.
- Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. The journal of sexual medicine. 2015;12(8):1660-1686.
- Khera M, Adaikan G, Buvat J, et al. Diagnosis and Treatment of Testosterone Deficiency: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). The journal of sexual medicine. 2016;13(12):1787-1804.
- Morales A, Bebb RA, Manjoo P, et al. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. CMAJ. 2015;187(18):1369-1377.
- Lunenfeld B, Mskhalaya G, Zitzmann M, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. The ageing male : the official journal of the International Society for the Study of the Ageing Male. 2015;18(1):5-15.
- Saad F, Aversa A, Isidori AM, Zafalon L, Zitzmann M, Gooren L. Onset of effects of testosterone treatment and time span until maximum effects are achieved. Eur J Endocrinol. 2011;165(5):675-685.
- Saad F, Caliber M, Doros G, Haider KS, Haider A. Long-term treatment with testosterone undecanoate injections in men with hypogonadism alleviates erectile dysfunction and reduces risk of major adverse cardiovascular events, prostate cancer, and mortality. The ageing male : the official journal of the International Society for the Study of the Ageing Male. 2020;23(1):81-92.
- EAU Guidelines on Sexual and Reproductive Health, 3. Male Hypogonadism 2022. Available at:https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Sexual-and-Reproductive-Health-2022_2022-03-29-084141_megw.pdf. Accessed February 2022.
- Corona G, et al. Andrology. 2020:8;970–87.
